Surgical Outcomes

Partnering to Improve Children's Surgical Care

If your child needs surgery, you're concerned about many things. Your number one priority: operation goes off without a hitch, without any complications or problems during, or after, the procedure.

Here at Nemours, that’s what we want, too. And that’s why we’re one of four hospitals leading a first-ever effort to get other children’s surgical programs across the country to report their outcomes (that is, the results of their care).

How It Works

Joining Forces for Changes in Kids' Surgical Care

We worked with Yale New Haven Children’s Hospital, Children’s Hospital Colorado, and Children’s Hospital of Wisconsin to collect and analyze our hospitals' surgical data and compare what we found to each other. Then, we asked other children's surgical programs nationwide at children's hospitals and hospitals with pediatric wings to do the same.

We’re proud to say that 29 children's surgical programs signed on to have their 2010 data collected and analyzed, through a groundbreaking new initiative called the "National Surgical Quality Improvement Program-Pediatric" (a partnership of the American College of Surgeons and the American Pediatric Surgical Association, called “ACS NSQIP-Peds,” for short). Now, an incredible 44 programs are on board.

How It Works

We (and the other participating children's surgical programs) use the tools provided by NSQIP-Peds to collect our data (results). Then, we submit that data to NSQIP-Peds and they compile a report every year showing how we’re doing versus other children’s surgical programs. We use that information to take a closer look at our processes and procedures to see where we could make things better.

What This Means to You

What This Means to You

At Nemours/Alfred I. duPont Hospital for Children, we’re a national leader in surgical results and overall quality of surgical care. That’s why we’re so focused on surgical outcomes and why we’re thrilled to be part of this National Surgical Quality Improvement Program-Pediatric (NSQIP-Peds) initiative. It’s important to us, and to your family, because:

1. This has never been done before.

It’s the very first time this kind of outcomes data is being collected and analyzed for multiple surgical subspecialties at pediatric institutions nationwide.

2. We now have national children's hospital data (or "benchmarks")
to compare ourselves to.

It's more than just about knowing other children’s hospitals’ outcome numbers. It’s about taking a good, hard look at how we do things and taking action steps to improve wherever we see opportunities. It’s about holding ourselves up to the highest standards.

3. All of this makes for a safer experience for children here at our hospital and nationwide.

We want to prevent complications so kids everywhere can stay healthy and have a faster recovery and a shorter hospital stay so they can go home and get back to their lives as soon as possible.

Why Do We Share Our Outcomes?

We don’t have to report our outcomes, but we want to. We want to be honest with families like yours about how we’re doing. We want to find out how we compare so we can make sure we’re delivering the very best care we can for kids. We want to improve care for children who come to us needing surgery to prevent complications and save lives.

Three Key Outcomes

A Few Key Outcomes We Focus On

When your child needs surgery, you’re probably thinking about a lot of the same things we are — that you don’t want your child to have:

  • to come back to the operating room for the same problem
    (also called, “unplanned return to the operating room”)
  • complications or problems after surgery
    (also known as, “postoperative occurrence-related cases,” which relate to the operation itself)
  • any problems with the surgical wound
    (also called, “wound occurrences,” when there’s a complication, like an infection, with the surgical wound where the surgeon cut into the skin)

To make sure we’re giving every child we see the very best care we can, we keep tabs on how we’re doing with all of these outcomes and many more. We look at both inpatient and outpatient procedures (that’s operations done on children staying in the hospital, as well as those who are able to go right home after surgery).

How We Give Kids Top Care

How We Give Kids the Best Care We Can

To help keep children from having complications and unplanned surgeries after their initial operation, we've tracked our outcomes and made improvements to some of our processes. Now, because of what we've learned over time, we:

Evaluate and prepare (prep) children before their procedure to make the surgical experience as streamlined and family-focused as possible.

Our experienced and specialized advanced practice nurses (APNs):
  • Review your child's records.
  • Perform a detailed physical exam.
  • Go over your child's medications, past problems, and current medical needs with you to inform the surgeon and anesthesiologist and avoid any unexpected events during surgery.
  • Explain what you might be able to expect during and after surgery — and introduce tools within our award-winning electronic health record (or EHR, for short) like (animation videos that explain certain procedures) and (the online parent portal of our EHR that helps families communicate with their care team and keep track of their child's care).
Encourage all of our patients' families to sign up and use MyNemours.

By using MyNemours, families can immediately report a problem and make sure it gets noticed and noted in the system. Someone from our post-anesthesia care unit (PACU) will call you and then contact your child's surgeon right away.

Make a follow-up call within 24 hours after surgery to make sure everything is OK.

We ask questions about how your child's feeling and how the surgical wound looks (and is healing) so that we can address any concerns as soon as possible.

Give antibiotics and use other state-of-the-art infection prevention techniques as indicated before an operation.

This helps curb infection during and after the procedure.

Review all infections related to central lines.

We want to make sure the proper processes were followed in the hospital and at home. (Read about how we're working to reduce and eliminate central line infections in our intensive care units.)

Review and discuss unusual infections and complications after surgery with every member of the division (including the surgeons, physicians, nurses, etc.).

We want to find out what happened and what, if anything, could have been done to prevent the complication.

Strictly follow the "time-out process" with every surgery.

Before every procedure, everyone on the operating room team pauses and checks all of the child's identification information such as the ID band and birth date, the chart, and any radiology scans (X-rays, MRIs, etc.) to make sure they're performing the right operation on the right child, on the right side, and the right part.

Continue to keep track of the child's progress after surgery.

We look at it over time to see if any complications were related to our process, related to the child's condition, and more.

In any surgery, there's always the possibility of complications. But our goal is to limit the potential problems, as much as possible, that we know we can control.

Outcomes by Specialty

Our Surgical Outcomes in Specific Specialties

Of course, when your child needs an operation, you want to know about your surgical team. So let’s take a look at outcomes as they relate, specifically, to each of the following surgical subspecialties at duPont Hospital for Children:

  • Neurosurgery
  • Otolaryngology (Ear, Nose, Throat) Surgery
  • Pediatric Surgery
  • Urologic Surgery
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Your child. Our promise.

If your child needs any kind of operation performed by our surgeons, you can rest assured that you’re getting top-notch surgical care from some of the best pediatric surgical subspecialists in the field. Our surgeons and all of our team members care for all of the children we see here as we would our own. Just like we’d want our kids to have a successful surgery that sets them on the path to feeling better, we want the same for your child. Always.